Late complications of Prostakath treatment for benign prostatic hypertrophy

The self-retaining intra-urethral device "Prostakath" was inserted in a consecutive series of 29 men with obstructive benign prostatic hypertrophy. Fifteen patients were relieved of prostatic symptoms for an observation period of 22 weeks (range 2-60). The spiral was removed in 14 cases (48%) at an average of 14 weeks (range 1-82) after insertion; in 9 patients this was because of urinary retention and in 5 it followed dislocation of the stent into the bladder. Five stents removed after 44 weeks of treatment (range 21-82) were severely calcified. Light microscopic investigation of the Spirals that were removed revealed no damage to the gold-plated surface. All patients with calcification had chronic urinary infection resistant to antibiotic treatment. We believe that infected urine is the major factor responsible for the calcification. We suggest that patients with recurrent urinary infection after insertion of the Prostakath should be closely followed up and checked for stone formation by a plain X-ray of the bladder region. It may be advisable to change the Prostakath in patients with resistant urinary tract infection at 6-monthly intervals.